While watching the news this morning, I was alerted to the practice of “combo-pilling,” taking supposedly unrelated medications together to produce more powerful results toward a desired outcome. Combo-pilling diet drugs went mainstream in the 1980s, with the pairing of phentermine and fenfluramine (later known as “fen-phen”). This pairing, as well as a commercial related version, was heralded as the first effective weight loss drug treatment. Later, when it was discovered that the commercial drug was associated with potentially fatal pulmonary hypertension and heart-valve problems, it was withdrawn from the market and the manufacturer was sued to the tune of more than ten billion dollars.

Combo-pilling remains, in part because single diet drugs have not yielded the results many seek. After sibutramine (Meridia) was removed from market late last year, the only FDA-approved drug for treating obesity for more than a few weeks is orlistat. However, if dieters eat fat-heavy meals, the results are some less-than-pleasant side effects (oily stains on one’s underwear, being one).

So combo-pilling continues.

Of late, the blend of Topomax, an anticonvulsant approved for the treatment of epilepsy and migraines; and phentermine, the above referenced appetite suppressant, are making their way into the collective dieters’ consciousness. It appears that Topomax effectively “shuts off” the desire to eat. When combined with phentermine, the results can be downright staggering. I monitored some on-line discussion groups and found it not uncommon for participants to claim weight losses of four or five pounds a week for extended periods. (A healthy sustainable weight loss is considered to be one to two pounds per week.)

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